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Healthcare leaders concerned reform is too costly, too aggressive

Posted Jun 23 2010 7:21am

By Mike Stephens
Former CEO, Hoag Memorial Hospital Presbyterian 

There are certain initiatives central to the success of healthcare reform that are likely to fail to meet expectations because good intentions will meet the reality of this country's fragmented healthcare system. Those initiatives, in my opinion, are the transition to electronic health records and the establishment of the patient centered medical home.

A recent article in The New York Times reported that executives of the most technologically advanced integrated healthcare networks in this country met with the White House and Medicare officials to explain that even their organizations could not achieve all the requirements necessary to meet the meaningful use standards established by the government. Pointing out the fallacy of the 2015 deadline, one executive commented it would require his organization to "have an advanced, sophisticated patient information system in place in order to obtain the money necessary to install even a basic system."

Another concern is transitioning physician practices to “patient centered medical homes.” A recent article in The Wall Street Journal describes a costly situation in Pennsylvania. A pilot program called the Chronic Care initiative involves 800 physicians and 16 health insurers. The cost? $30 million over three years in extra payments to assist traditional physician practices in establishing this type of team approach to patient care.

So far, in situations where this type of transformation actually happened, it required tremendous effort and motivation, the addition of electronic medical records and significant training and staff reorganization. But what we don’t know yet is whether this change can be implemented broadly without the investment of the billions of dollars to support the change nationwide. 

These issues are just two examples of some of the difficult hurdles ahead. Changing the healthcare delivery system in the United States is no small task, especially when you consider that until now, the system has remained basically free of broad government control and true economic competition. 

If the health systems that have been most successful in introducing meaningful change find the future prospects of meeting government reform expectations unrealistic, too costly and too aggressive, what does that mean for those who have yet to begin the journey?

Efficient hospitals told to pay up!

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